Clearness and expansion (Prasáda) of the intellect, firmness of the organs and of the Dhátus (root-principles) of the body, increase of energy (Bala) *, improved digestive capacity and a lata or delayed old age are the blessings which follow a proper administration of purgative remedies. The deranged Pitta of the system, having been fully removed (with the help of a purgative), precludes the possibility of the existence of any Pitta-origined complaint, just as the waters of a tank or any other reservoir of water, having been fully baled out, bar against the possibility of the existence of all aquatic animals and plants living therein. 18.
Persons who should not be purged:
- Exhibition of purgatives are prohibit d in respect of persons of impaired digestion, or of those treated with an excessive application of any emulsive remedy (Sneha-Karma), or of those who are exceedingly corpulent, too old, fatigued, thirsty or intoxicated, or of those suffering from any ulcer. They are similarly prohibited in respect of frightened persons and Kshata-kshina patients or of those afflicted with haemorrhage from the downward orifices of the body or of persons with any dart or foreign matter (salya) lying imbedded in the organism as well as in respect of infants and enciente. A purgative medicine should not be administered before the digestion of a meal previously taken, neither in the diseases due to an abuse of wine, nor in acute catarrh and acute fever or to a newly parturient woman and persons not previously treated with a Sneha (oil or Ghrita). A mild purgative may, however, be administered (in cases of emergency) to a person of extremely Pitta-predominant temperament. Purgatives administered by ignorant physicians to persons who ought not to be purged (often) prove fatal. 19.
* Vrinda does not include "Bala" (energy) in the list.
The distempers of the body in which a purgative should be exhibited with good results are: - fever, effects of slow chemical poison (retained in the system), an aversion to food, haemorrhoids, tumours (Arvuda), ascites (Udara) glandular swellings (Granthi), abscess (Vidra-dhi), jaundice, hysteric convulsions (Apasmára), heart-disease, Váta-rakta, vaginal or uterine diseases, fistula-in-ano, vomiting, erysipelas (Visarpa), Gulma, pain in the Pakvásaya (intestines), retention of stool, Visu-chiká, Alasaka, strangury (Mutrágháta), cutaneous affections (Kushtha), Visphotaka (carbuncle, etc.), Prameha, distension of the abdomen with the suppression of stool and urine (Anáha), enlargement of the spleen, œde-matous swellings (Sopha), Vriddhi (enlargement of the scrotum, etc.) and kindred complaints, ulcers inflicted by weapons, alkaline scalds and burns, malignant ulcers, (Dushta-vrana), inflammation of the eyes (Akshi-páka) Kácha, Timira, conjunctivitis (Abhishyanda), burning sensations in the head, ears, eyes, nose, mouths, anus and the penis, haemorrhage from the upper channels (Urdhva-Rakta-pitta), worms, diseases of the Pittásaya (bowels?) i.e., the diseases which are peculiar to the seats of the Pitta in the organism as well as any other disease due to an aggravation of the Pitta. 20.
Emetic and purgative remedies, in spite of their possessing in common the powers of motion (Saratva) subtlety, keenness, ex-pansiveness and heat-making properties, tend to remove the injurious and deranged morbific principles (Doshas) of the body in (two) different ways by virtue of their respective inherent qualities (Prakriti) *. A purgative, in the course of its digestion, carries down with it all the Doshas from the system (loosened and dislodged by virtue of its own specific properties). An emetic, on the other hand, is not digested, owing to (its lightness due to) its inherent extraordinary qualities †, but it soon forces its way up with the Doshas (to be) removed. 21-22,
A strong purgative given to a man of loose or lax bowels (Mridu-Koshtha) or of strong digestive capacity, cannot remove all the Doshas fully owing to their being suddenly and forcibly purged off. 23.
A purgative medicine, which is capable of being digested and of expelling the Doshas from the body in the time which a morning meal ordinarily takes to be digested, should be regarded as pre-eminently the best. 24.
* Dallana quotes a different reading which means that emetic and purgative remedies produce the wished-for result, if properly administered, otherwise not.
† The extraordinary qualities of an emetic are those of the Váyu and of the Agni.
The (aggravated) Doshas accumulated in a large quantity in the organism of a weak patient and found to be dislodged from their seats should be gradually expelled from the system, while soothing (S'amana) remedies should be used in cases of the Doshas being very slight, even if they be found to have been dislodged from their seats. The aggravated Doshas matured and spontaneously dislodged (from their seat or place of accumulation in the system) should be purged off, whether the patient be strong or weak, inasmuch as, if neglected (and not expelled from the system) they (Doshas) tend to produce lasting troubles. 25-26,
A purgative should be administred to a patient of impaired digestive capacity and extreme habitual constipation of the bowels (Krura-koshtha) after having improved his digestion with the admixture of rock-salt, Yava-kshára and clarified butter and after applying Sneha and Sveda (as usual). A purgative remedy used after a due application of Sneha and Sveda to the body, leads to the looseness and dislodgment per force of the aggravated Doshas from their seats, since they do not adhere to the internal channels and passages just as a drop of water does not adhere to a pot or vessel saturated with a Sneha. An oleaginous purgative should not be given to persons who have already taken internally * an abundant quantity of Sneha, as it would tend to make the aggravated Doshas of the body dislodge from their seats and again adhere to the internal channels and passages. 27-28.
An excessive quantity of Sneha should be used in cases of poisoning, hurt, pustular eruptions (Pidaká), oedema and cutaneous affections before the application of purgatives or emetics. The body of a patient, habit uated to the use of oleaginous articles (Sneha), should be first made dry (Ruksha). Sneha should then be used again as usual and purgatives or emetics applied. The aggravated Doshas would be thereby expelled from the system and the patient would grow stronger *. 29-30.
* Vrinda reads in place of 'This means that the Sneha might have been used both internally and externally.
Mild emetics and purgatives should be given at the outset to a person to be treated with such medicines, who had never taken any purgative or emetic before-Emetics and purgatives should then again be administered to him, after thus finding out the state and nature of his Koshtha (bowels). An emetic or purgative medicine of tested efficacy and which is pleasant, aromatic, agreeable and small in dose but of mighty potency should be given to a king; (in addition to these qualities) the medicine should be such as would not produce any serious injury. 31-32.
The body (health) of a patient to whom a purgative or emetic medicine is administered without first applying Sneha and Sveda thereto breaks up like a piece of sapless wood at the time of bending it. The aggravated Doshas dislodged from their seats in the organism through the effects of Sneha and Sveda and stirred by emollient food † are easily expelled by emetics and purgatives. 33.
Thus ends the Thirty-third Chapter of the Chikitsita Sthánam in the Sus'ruta Samhitá which deals with the treatment of diseases amenable to the use of emetics and purgatives.
* Vrinda reads in place ofThis means that the Doshas, so long obstructed by Snche, are thereby expelled, † Some explainto mean "with emollient meatsoup".